Do you Know what the Obama Plans Cover?

May 15, 2011
By

AFFORDABLE TEXAS HEALTH INSURANCE PLANSHumana exchange rates here…..
https://www.humana.com/insurance-plan-quotes/AOALanding?SANID=1263296

BLUE CROSS BLUE SHIELD (BCBS) exchanges rates here…..
https://retailweb.hcsc.net/retailshoppingcart/TX/census?ExpressLinkedAgentId=4691

Affordable Healthcare Reform Act.

It is astounding to me how so few of you know about what the new “Obama” plans actually cover. Here is the list of benefits that are now mandated by the government to be covered by your insurance carriers:
Covered Preventive Services for Adults

  • Abdominal Aortic Aneurysm one-time screening for men of specified ages who have ever smoked
  • Alcohol Misuse screening and counseling
  • Aspirin use for men and women of certain ages
  • Blood Pressure screening for all adults
  • Cholesterol screening for adults of certain ages or at higher risk
  • Colorectal Cancer screening for adults over 50
  • Depression screening for adults
  • Type 2 Diabetes screening for adults with high blood pressure
  • Diet counseling for adults at higher risk for chronic disease
  • HIV screening for all adults at higher risk
  • Immunizationvaccines for adults–doses, recommended ages, and recommended populations vary:
    • Hepatitis A
    • Hepatitis B
    • Herpes Zoster
    • Human Papillomavirus
    • Influenza
    • Measles, Mumps, Rubella
    • Meningococcal
    • Pneumococcal
    • Tetanus, Diphtheria, Pertussis
    • Varicella
  • Obesity screening and counseling for all adults
  • Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk
  • Tobacco Use screening for all adults and cessation interventions for tobacco users
  • Syphilis screening for all adults at higher risk

Covered Preventive Services for Women Healthcare, Including Pregnant Women

  • Anemia screening on a routine basis for pregnant women
  • Bacteriuria urinary tract or other infection screening for pregnant women
  • BRCA counseling about genetic testing for women at higher risk
  • Breast Cancer Mammography screenings every 1 to 2 years for women over 40
  • Breast Cancer Chemoprevention counseling for women at higher risk
  • Breast Feeding interventions to support and promote breast feeding
  • Cervical Cancer screening for sexually active women
  • Chlamydia Infection screening for younger women and other women at higher risk
  • Folic Acid supplements for women who may become pregnant
  • Gonorrhea screening for all women at higher risk
  • Hepatitis B screening for pregnant women at their first prenatal visit
  • Osteoporosis screening for women over age 60 depending on risk factors
  • Rh Incompatibility screening for all pregnant women and follow-up testing for women at higher risk
  • Tobacco Use screening and interventions for all women, and expanded counseling for pregnant tobacco users
  • Syphilis screening for all pregnant women or other women at increased risk

Covered Preventive Services for Children

  • Alcohol and Drug Use assessments for adolescents
  • Autism screening for children at 18 and 24 months
  • Behavioral assessments for children of all ages
  • Blood Pressure screening for children
  • Cervical Dysplasia screening for sexually active females
  • Congenital Hypothyroidism screening for newborns
  • Depression screening for adolescents at higher risk
  • Developmental screening for children under age 3, and surveillance throughout childhood
  • Dyslipidemia screening for children at higher risk of lipid disorders
  • Fluoride Chemoprevention supplements for children without fluoride in their water source
  • Gonorrhea preventive medication for the eyes of all newborns
  • Hearing screening for all newborns
  • Height, Weight and Body Mass Index measurements for children
  • Hematocrit or Hemoglobin screening for children
  • Hemoglobinopathies or sickle cell screening for newborns
  • HIV screening for adolescents at higher risk
  • Immunizationvaccines for children from birth to age 18 —doses, recommended ages, and recommended populations vary:
    • Diphtheria, Tetanus, Pertussis
    • Haemophilus influenzae type b
    • Hepatitis A
    • Hepatitis B
    • Human Papillomavirus
    • Inactivated Poliovirus
    • Influenza
    • Measles, Mumps, Rubella
    • Meningococcal
    • Pneumococcal
    • Rotavirus
    • Varicella
  • Iron supplements for children ages 6 to 12 months at risk for anemia
  • Lead screening for children at risk of exposure
  • Medical History for all children throughout development
  • Obesity screening and counseling
  • Oral Health risk assessment for young children
  • Phenylketonuria (PKU) screening for this genetic disorder in newborns
  • Sexually Transmitted Infection (STI) prevention counseling and screening for adolescents at higher risk
  • Tuberculin testing for children at higher risk of tuberculosis
  • Vision screening for all children

It is also important for you to know what is NOT covered under the Act.
Your agent may tell you that all plans cover your wellness for free. This is not entirely true. Buyers beware. While a number diagnostic tests and screenings are part of the wellness services benefits, other charges related to those services SUCH AS OFFICE VISITS AND PHYSICIANS FEES MAY NOT BE. IT IS ALL UP TO THE INDIVIDUAL INSURANCE CARRIER AND THE CODES THAT ARE ENTERED ON YOUR BILL.  What I am getting at here is though all of the screenings above will be covered, the actual doctor’s visit may not be. The language is confusing and is open to dangerous interpretation. I wanted to just let you know so you have the REAL TRUTH on the matter.  Demand that your agent be specific when she/he explains how preventive care is covered under your new plan. Cost sharing will be required for certain services including annual physicals for adults 21 and over. Prostate screenings for men are not covered either. So when you go to your next physical, you must be proactive and ask the billing department to code your visit as a wellness visit so your screenings will be covered with no cost sharing.

2 Responses to Do you Know what the Obama Plans Cover?

  1. Cassmeyer on April 1, 2012 at 5:51 am

    I like the helpful information you supply in your articles. I’ll bookmark your weblog and check once more here regularly. I am moderately sure I will be told lots of new stuff proper right here! Best of luck for the following!

  2. chlamydia on May 7, 2012 at 9:57 am

    Its like you learn my thoughts! You seem to know a lot approximately this, such as you wrote the e book in it or something. I believe that you simply could do with some % to pressure the message home a bit, but other than that, that is excellent blog. A fantastic read. I’ll definitely be back.